When Your Lifestyle Is Your Disease

Maybe it's time for doctors to treat unhealthy behaviors just as they would any medical condition.

Patients generally go to the doctor to find out what's wrong with them or to make sure there's nothing wrong with their health. But what if doctor visits became a chance to get a professional evaluation of the way your lifestyle is impacting your health — a session with a health coach and a chance to be referred to experts to help you prevent disease rather than deal with it after the fact?

To address the poor state of Americans' health, the American Heart Association (AHA) has just issued a Call to Action in the journal, Circulation, urging doctors to actively treat unhealthy lifestyle choices — overeating, smoking, not exercising — as they would treat any other health condition.

Doctors can’t measure the effects of these behaviors with a lab test, but they know the outcomes: an increased risk of multiple chronic diseases, like cancer and diabetes, and a far higher likelihood of early mortality.

What if doctor visits became a chance to get a professional evaluation of the way your lifestyle is impacting your health — a session with a health coach and a chance to be referred to experts to help you prevent disease rather than deal with it after the fact?

ADVERTISEMENT

So it makes sense that rather than waiting for these diseases to show up, doctors should try to short-circuit the cycle and begin to help their patients address the lifestyle choices that lead to them with an arsenal of the best tools and specialists available.

“We already treat physical risk factors that can be measured through a blood sample or a blood pressure reading in a doctor's office, yet people put their health at risk through their behaviors,” said Bonnie Spring, a health psychologist and primary author of the Call in a statement. “We can't measure the results of these behaviors in their bodies yet,” but because the medical community knows so well what kinds of outcomes unhealthy lifestyles lead to, it makes sense to help the person change their unhealthy behaviors before they result in disease.

Among the steps the AHA is urging doctors to carry out:

Assess a patient's risk behaviors for heart disease;

Advise change, such as weight loss or exercise;

Agree on an action plan;

Assist with treatment;

Arrange for follow-up care.

The implication here is that different areas of medicine will have to collaborate closely to help treat each person’s health concerns. For example, if someone is overeating and sedentary, he or she might benefit from the help of a dietitian, a mental health professional, and a trainer, depending on the nature of the problems. If a person is trying to quit smoking, an addiction specialist, a community or online support group, and/or medication may be what's needed.

ADVERTISEMENT

To make these types of changes realities, the authors urge that healthcare become a more collaborative effort. Reimbursement policies also need to be revamped, they say.

“We're talking about a ...shift from only treating biomarkers — physical indicators of a person's risk for heart disease — to helping people change unhealthy behaviors, such as smoking, unhealthy body weight, poor diet quality and lack of physical activity,” said Spring, Director of the Center for Behavior and Health at Northwestern University's Feinberg School of Medicine.

Unhealthy behaviors are often a complex blend of habit, cultural influences, and emotional issues. They frequently don’t have any easy fixes, so it’s all the more important to develop a team of professionals — and other supporters — to address the problem in the most thorough way possible.

As many have argued before, prevention is the best medicine, even if we don’t always think that way. But our growing awareness of healthy behavior and the new proposal by the AHA should help push prevention as the best tool for public health even further.

“This isn't a problem that can be solved alone by the patient or the doctor who is strapped for time,” Spring added. “We need to break out of our silos and get ahead of the curve in prevention.”